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Joint Stiffness is the feeling that the motion of a joint is limited or difficult. The feeling is not caused by weakness or reluctance to move the joint due to pain. It is the sensation of difficulty moving a joint or the apparent loss of range of motion of a joint. Stiffness often accompanies joint pain and/or swelling. Depending on the cause of joint stiffness, joint redness, tenderness, warmth, tingling, or numbness of an affected area of the body may be present. It can be caused by injury or disease of the joint and is a common finding in the arthritis conditions. Joint damage, including stiffness, can also occur following injury to the joint.

Joint stiffness is a highly prevalent symptom commonly associated with pain and arthritis, the leading causes of disability in the older population [rx, rx]. Approximately 30% of adults in the U.S. report joint stiffness, aching or pain in the preceding 30 days and 50% of these adults are over the age of 75[rx]. However, the ramifications of chronic joint stiffness in older adults are poorly understood because the information is limited on the impact of this condition on health, activity limitations, and health-related quality of life in the older population [rx, rx]. Joint stiffness and pain can be caused by a number of highly prevalent chronic musculoskeletal conditions associated with aging, including osteoarthritis (OA), rheumatoid arthritis (RA), spinal stenosis/disc disease and past injuries [rx].

Causes of Stiffness / Joint Stiffness

A number of common injuries can cause stiff joints. These injuries include

Osteoarthritis – which is the degeneration of the cartilage over the parts of the bone involved in the joint (articular cartilage). It is often associated with long term wear and tear of the cartilage with reduced regenerative capacity of the cartilage. Osteoarthritis is the most common type of arthritis mainly seen in the elderly.

Rheumatoid arthritis – is inflammation of the joint lining caused by the immune system attacking these tissues (an autoimmune disorder). The small joints of the hands and feet are more commonly affected. The exact cause is unknown but it appears to be linked to genetic factors and may be triggered by certain environmental factors or infections.

Gout – or more correctly gouty arthritis, is an accumulation of uric acid crystals in the joint space. It presents with painful swelling and redness of the joint, mainly of the big toe. Gout arises when the uric acid levels in the blood are significantly elevated (hyperuricemia).

Pseudogout – is similar to gout but is instead caused by an accumulation of calcium pyrophosphate crystals.

Septic arthritis – is an infection within the joint most commonly caused by bacteria. The immune reaction coupled with the bacterial toxins can damage the joint lining within a short period of time. It is therefore considered to be the most serious form of arthritis warranting emergency medical attention.

Reactive arthritis – is joint inflammation associated with an infection an a site other than the joint itself. It is a result of an immune response triggered by a bacterial infection that then leads to pronounced joint inflammation. Reactive arthritis is also known as Reiter’s syndrome.

Arthrosis – is the wearing down of the cartilage that precedes osteoarthritis.

Symptoms of Stiffness / Joint Stiffness

Stiffness may be either the symptom of pain on moving a joint, the symptom of loss of range of motion or the physical sign of a reduced range of motion.

Pain on movement – is commonly caused by osteoarthritis, often in quite minor degrees, and other forms of arthritis. It may also be caused by injury or overuse and rarely by more complex causes of pain such as infection or neoplasm. The range of motion may be normal or limited by pain. “Morning stiffness” pain which eases up after the joint has been used, is characteristic of rheumatoid arthritis.

Loss of range of motion – the examining medical professional notes that the range of motion of the joint is less than normal. A routine examination by an orthopedic surgeon or rheumatologist will often pay particular attention to this. The range of motion may be measured and compared to the other side and to normal ranges. This sign is associated with the same causes as the symptom. In extreme cases when the joint does not move at all it is said to be ankylosed.

Pain – Pain from arthritis can be constant or it may come and go. It may occur when at rest or while moving. Pain may be in one part of the body or in many different parts.

Swelling – Some types of arthritis cause the skin over the affected joint to become red and swollen, feeling warm to the touch. Swelling that lasts for three days or longer or occurs more than three times a month should prompt a visit to the doctor.

Difficulty moving a joint – It shouldn’t be that hard or painful to get up from your favorite chair.

Regular exercise to improve muscle tone and fitness can be very beneficial. Choose a gentle exercise that won’t cause pain such as yoga or swimming.

If stiffness is the result of muscle tension or stress, treat yourself to a monthly massage and learn to manage stress levels better.

Make sure that you adopt a good posture at all times and check that your furniture such as sofas and your mattress is conducive to a healthy posture.

Use a hot water bottle or heat pad to provide relief for sore joints in cold weather.

Medicine

DMARDs – These antirheumatic drugs work to reduce the inflammation RA brings on. Some traditional DMARDs accomplish this by wiping out the whole immune response. More recent versions of these drugs, known as biologics, target particular steps along the inflammation process. DMARDs may be injected, taken orally, or give at the doctor’s office via infusion.

NSAIDs –These common pain relievers help reduce pain and inflammation. This class of drugs includes ibuprofen,naproxen, and the prescription drug celecoxib. A patient may be instructed to take these orally or on the skin as a patch or cream.

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